The best you can do is research the complications and weigh the risks. It comes down to how serious your height neurosis is. Remember theres worse things that can happen than joint pain too.
As you've already lengthened your legs in Russia, why don't you tell us what Dr Bagirov says about this.
Quote from: programdude on April 08, 2015, 05:44:10 PMThe best you can do is research the complications and weigh the risks. It comes down to how serious your height neurosis is. Remember theres worse things that can happen than joint pain too.
Yeah I know about the worst that can happen. Nonunions. Nerve damage. Avascular necrosis. Broken nails. But knowing that I'd be going with a top surgeon like Guichet if I did anything, I'm not really worried about that stuff. What bothers me mentally is the idea that even in a best case scenario I may not be able to avoid chronic joint pain, and that this is not going to be predictable. I don't have bowlegs. So my alignment would be worsened by going to x-legs.
For reference I found Dr. Birkholz's discussion on the mechanical axis here:
http://www.limblengtheningforum.com/index.php?topic=137.msg6963#msg6963
To quote the most relevant passage:
Question: "So your saying if anyone does 8cm on their femurs they WILL get knee pain and arthritis in the future?
Answer: "No, they will get a change in alignment. This may lead to knee pain and arthritis. It is very individual, but we cannot really predict who will and who wont."
I am thinking internal femurs may be not a good tradeoff. Yes they're faster and simpler. But even done perfectly, they create the greatest shift in mechanical axis.
I'm going to look a bit further into tibial. I see the Guichet and Precise nails can both be used in tibias, though I've never seen diaries with anyone getting either. Those seem like the best tibial options for those of us who don't want or can't afford a cage and wheelchair. Again I haven't found any diaries/experiences for either though. If anyone has any good links on the subjects I'd appreciate it.
I think femur is just going to be off the table for me. I want the height, speed, and ease, but not the inevitable misalignment. The best case scenario with femurs is still too risky. With tibias I'm worried by the stories I read of intoeing/outtoeing. But at least with tibias, theoretically if it's done well, the mechanical axis is almost perfectly preserved.
Things like ballerina ankle on tibial lengthening also don't worry me because it's a soft tissue issue which should eventually stretch out and resolve if you are young/healthy/diligent and do adequate pre-stretching. It's the bone misalignments that are most worrisome, because those are not physio-correctable. And the bone misalignments seem unavoidably greatest with internal femurs.
Overall, looking at the situation, I think I would rather take a few months extra and do internal tibias, even settling for a smaller growth, if it comes with a probability of less mechanical axis disruption. I expect I will eventually in a year or so be going for consults on this. I already know I will never be happy at my current height. I can raise these questions with the surgeons I'm looking at (Paley, Guichet) then. But that's a long time from now. If anyone is having any interactions with their respective surgeons before then and can see what they say, it could be helpful to a lot of us.
I wish there was some perfect solution. I wish we could all be tall and not have to take these giant risks. But in a way we're lucky because LL has never been more advanced or safer. We just have to do our homework now to find and pick the safest routes, since there are so many choices. 
Thanks for the feedback, guys. Any other thoughts on all this would be very welcome.
Not every person has hurt knees. Some have none knee pain after lengthen.
no knee pain here
btw... if that x ray is considered minor valgus... my left leg is badddddddd.... its much worse than that.... much
i was going to post an x ray photo to show how my left leg looks... but u cant even upload a photo here
its really annoying... i dont have a photobucket account... but to post any media here,it seems one must create other accounts
maybe this works
this is not my x ray..
my right leg is fine.. but my left leg x ray from the front looks like this, but mine might be worse
https://www.google.com/search?q=genu+valgum&espv=2&biw=1435&bih=702&source=lnms&tbm=isch&sa=X&ei=FnMlVcaxGYTUsAWp3YGAAg&ved=0CAYQ_AUoAQ#imgrc=tCZP1r09_ym45M%253A%3BTHHwIqgUUGFFJM%3Bhttp%253A%252F%252Fwww.bjj.boneandjoint.org.uk%252Fcontent%252F92-B%252F2%252F273%252FF1%252Fgraphic-1.large.jpg%3Bhttp%253A%252F%252Fwww.boneandjoint.org.uk%252Fcontent%252Ffig-1a-fig-1b-244%3B783%3B1280
Quote from: crimsontide on April 08, 2015, 06:33:14 PMi was going to post an x ray photo to show how my left leg looks... but u cant even upload a photo here
I use this free upload service with no account needed:
http://postimage.org/
Agreed though it's annoying you can't attach directly here since it means none of these photos will reliably be here in 5 years when someone else is looking to read this.
I'd love to see your xrays if you can post them there. Also please let us know how your joints feel. Hope you're doing okay enough.
if you look above, the front of my x ray looks like that... but only left leg
no aches, but getting leg fixed... its gotta be hurting my walking
Quote from: crimsontide on April 08, 2015, 06:44:01 PMif you look above, the front of my x ray looks like that... but only left leg
no aches, but getting leg fixed... its gotta be hurting my walking
This happened from external tibial extension for you? Did you ever ask your surgeon why they thought it might have occurred? I've read that the Chinese external tibial lengthening procedures allow you to control the medial vs lateral length of the tibia to try and avoid this kind of gross misalignment.
What do you think went wrong in your case? What is your surgeon offering you?
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